BLAKE N BROG

BOUNTIFUL, UT
NPI1871624403
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: UT  142188-9921)
Enumeration Date2007-03-07
Last Update Date2007-07-08
Business Address
Dr. BLAKE N BROG D.M.D.
469 MEDICAL DR
BOUNTIFUL, UT 84010-4900
Phone number: 801-292-1888
Mailing Address
Dr. BLAKE N BROG D.M.D.
469 MEDICAL DR
BOUNTIFUL, UT 84010-4900
Phone number: 801-292-1888
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